After a Suicide Attempt – for the Loved Ones

Meeting Of Support Group

You care about someone who recently attempted suicide. What is your role now? How can you be supportive, helpful, and useful to them? Should you pretend it never happened, or follow up? Will talking about it make them more likely to try again? These are difficult waters to know how to navigate.

They’re experiencing a lot of feelings right now, and may not be able to ask for – or know – what they need. They may feel like a burden to others and feel unable or unwilling to ask for what they need. To get another perspective, here is an article for the attempter.

Be available as much as you can, and check in. The rate at which to do this depends on your existing relationship. Do what feels comfortable, and maybe 1/2 a step more. You are not expected to have a perfect solution or fix anything. Ask how they’re feeling, sleeping, eating, and what they’re thinking. Skip the platitudes like “everything happens for a reason” and “there must be a purpose you’re still here” as they feel hollow to receive and don’t create lasting change or connection.

Sort out your own feelings by talking to a therapist of your own, the family support staff at the hospital or agency where your loved one is being seen, or a trusted friend who will keep confidential what has happened. You can still lean on your loved one, but they can only give you back so much right now as they deal with their own stuff, so keep your portion lighter than theirs for the time being, but don’t withdraw, either, or be afraid to talk about some of your struggles. They likely don’t want interactions to feel phony, surface, or like others cannot be themselves – this can lead to guilt. If you have guilt, sort through it knowing that a person has to be at a personal low in order to make an attempt, and your part in that, if any, was only a part, and there are more pieces that created the depth of pain. Despite your curiosity, do your best to avoid asking them why they made the attempt as expressing the level of pain it took to try to escape it may be impossible to verbalize; do encourage them to discuss it in therapy, though any decent therapist will be exploring this.

Ask what you can do to help. This could be: making some meals and dropping them off to be heated up later, helping them get clothing or makeup to cover the healing wound, just sitting together, or checking in on them by text daily. Sometimes they want to be left alone, and if it is safe to do so, respect that request, and make the offer. Make plans for the future, something to look forward to – a restaurant you haven’t tried yet, a return to a fun activity, a small trip.

It’s okay to ask if they feel suicidal, or are having thoughts, urges, or a plan to kill themselves. Of course, making that every interaction would be annoying to anyone, but asking does not increase suicidality. You could also ask what the plan is if those feelings/thoughts return, and have a ready plan in place (mobile crisis unit, hospital, psychiatrist, therapist, who they will tell, if not you). It is relevant to know that suicidal thoughts are just thoughts, but urges and plans are more serious and safety actions can be mobilized at those later steps.

Be patient with them and with yourself as you each work through this. This part is going to suck for everyone. You’re enduring it together so you can all get through it.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Ruminating Recovery

Is there an issue in your life that has become the focus? Does it consume all your energy and thoughts, even when you’re otherwise occupied? Does it feel like intrusive thoughts about the same thing all the time? You’re likely ruminating.

I’ve described ruminating as “sitting in a dirty puddle with a wet butt.” It doesn’t feel good. You don’t want it, but you keep doing it. I’m here to offer you a hand up and out of the puddle, to get dry again, to feel better, to reclaim your energy. You must place your mind and face in the direction you wish to be going in order to do it differently. This is an active process and a conscious act.

Ruminating is thinking of something negative that makes you feel bad. It’s all-consuming and colors the rest of your day and life with a grey-wash.

How do I stop ruminating? Read this article. Then keep making the conscious decision to stop. Like any practice, it starts out hard and gets easier as you go. You may consider starting therapy (or discussing this with your existing therapist) to help you reframe, break bad habits, have support, or think differently during this process.

You might also like a mantra to support you in not engaging in rumination. I like “It is done. Make good choices.” Dr. Greenberg uses “Stop doing the math.” Pick a short statement that makes sense to you and your situation.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Ways to Self-Soothe

You’re having a bad day due to anxiety, depression, or just the general stress of being a human on this modern earth. You want ways to calm yourself when the things you know to try aren’t successful. Try these:

Pet an animal, real or stuffed, or a soft blanket, or a cozy sweater.

Sip a warm beverage, any that you enjoy (but you might skip the caffeine) like cocoa, tea, or coffee. You don’t have to follow Big Bang Theory’s protocol.

Take a warm shower or soak in the tub. Bonus if you have bubbles or something to add a pleasant scent. You don’t have to cleanse if you’re already clean, but bringing your core temperature up can be helpful.

Write or do art. Getting your emotions out of your body and onto the page can release pent up feelings. What you write/create makes no difference as it’s about expression, not creating something wonderful right now.

Move your body gently and briefly is fine. Take a walk around the block, dance to one song, check out some tai chi, or whatever you like best.

Massage your muscles by rolling your neck, using a foam roller, or rubbing your body with your hands.

Spend time in nature by visiting a local park, or even sitting on your porch and looking at the plants and creatures nearby.

What other tips do you enjoy that I haven’t listed?

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

How to be a Therapist When Your Life is Falling Apart

You are a human being in the real world and sometimes your life, like a taco, is going to fall apart. You still have a job to do. Some jobs are easier than others when heavy things are going on. Therapy isn’t one of them. You can take a sabbatical, maybe, cancel your clients for a day or two, or a week, but probably not much longer than that. Or you can keep working and get by. What to do is a very personal choice and depends on many factors that you will have to weigh. You might seek supervision about transferring your caseload while things settle down or how to proceed.

Doing the minimum Get up, take a shower, and get dressed. You can do the minimum if you have to for now. That may mean not shaving, not dressing well, or not styling your hair. It’s alright to do what you can. Even the minimum can be a lot sometimes. Go easy with yourself.

Being there for your clients when you don’t have anything to give Therapy is part conversation, part technique, part education, and part entertainment. When you’re depleted in your personal life, you may not feel able to do those things. Just show up. When the part of conversation that is yours drags, use silence; you didn’t choose to be a clown and don’t have to entertain all the time.

What do I say? But what if my clients notice I’m not myself, not cheerful, not energetic? Own it. Use it as a teaching moment to say “we’re all going through stuff and we all get by sometimes, even me, even you.” Let it be okay to not be okay all the time. Demonstrate the principles you teach. I also like the analogy “Sometimes I’m at 100% and I can give 100%, but sometimes I’m at 30% and that’s what I can give.”

How much to share Keep it to yourself to be ethical and process your stuff in your time. Use a blanket statement like “I’m just going through some things right now” or “things are just rough right now.” You don’t have to reassure your clients that you’re fine if you’re not, promise them you’ll be alright if you’re not sure you will be, or worry them unnecessarily. You also don’t want them guessing about your personal life, prying, or following up on your issues – that’s your job for them, after all.

Get therapy Don’t hesitate to get yourself therapy. Find one who is a good fit for your needs. Process your stuff. Do your homework. Be a good patient. It’s okay if you just cry the whole time. Sometimes just thinking about my therapy appointment coming up makes me cry because I’m holding it together the rest of the time until then. If you can’t cry in therapy, I don’t know where you can. Express any countertransference as it comes up.

Self care Oh boy is this a hard one! Sleep, eat decently, journal, get some gentle movement in like a walk, and drink water. Oh, and socialize and do your hobbies. You know, all that stuff you tell your clients about. I know you don’t want to and feel like you can’t; do what you can, then do a little more. Oh, I know how hard it is but you have to in order to have a chance at getting out of The Pit, and you need out. Even spending one minute on a self care activity can be progress, so mark that progress and go forward.

Referring out and consultation If there are certain topics that are too close to home right now (relationship issues, parenting issues, whatever the thing may be) or certain populations you cannot deal with right now, stop taking those new cases and refer out your existing similar cases. It’s the ethical thing to do, to let them continue their treatment with someone who has the capacity for them if you currently do not. Unsure how to do this or to whom to send them? Seek consultation. Ask your peers for recommendations on how to handle things that are sensitive for now. Consider taking a sabbatical if it’s possible for you to take a leave for awhile while you get things sorted out. Tell your clients only the brief statement you prepare in advance that does not inure them, like “I’m stepping away from my practice for now and am uncertain when I will return, but am providing you with 3 capable therapists to choose from that work with your needs and insurance. I’m emailing your their contact information and a link to their websites so you can decide who to work with.” Consultation can help you set up referrals and a statement like this. It probably won’t feel good to do, but having done it will feel like relief and will minimize countertransference.

Know that this, too, will pass. What is happening is hard, but you will persevere. You have survived every bad day so far. Keep going. Be gentle with yourself.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Your Needs in the Relationship – an exercise

Young African-American couple at odds and bad mood not talking with each other and looking away after heated argument

If you feel that you and your partner are not as connected as you’d prefer, are not headed in the same direction (either short-term or long-term), are not seeing eye-to-eye, or may not be a good continued fit, you may consider this exercise to examine your place in the relationship, your desires, and your goals for the future of the relationship. If you both do the exercise and discuss it, it may lead to increased awareness of your goals; be aware that this may not be a harmonious discussion.

Are your needs being met in your relationship? What are those needs? Some examples may be related to physical needs, emotional needs, and/or spiritual needs. Your topics may vary. Here is a sample outline:

  • Physical
    • Safety
    • Intimacy
  • Emotional
    • Safety
      • Financial
      • Boundaries
      • Trust
      • Privacy
    • Socialization
    • Communication
    • Intimacy
    • Progress
  • Spiritual
    • Understanding/respect of each other’s beliefs
    • Services or celebrations
    • Future goals

Here’s an article that fleshes the topics out in more detail.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Why me? and It’s not fair.

person walking in rain with red umbrella at night

When a traumatic event happens, most people are left with the question “Why me?” and the feeling of “It’s not fair.” What do you do with those and how do you move beyond the stuck feeling they leave you?

It’s not fair. No, it’s not. Much of real life isn’t fair and this thing is also not fair. There’s no making it fair. There’s no making it right. It was a terrible thing and it doesn’t have to be better or make sense or fit in with an idealized version of reality. Some things just suck and this is one of them. It’s okay that this is how it went down. Fighting the unfairness of it is futile. Allow it to be unfair and you’ll stop coming up against this obstacle.

Why me? No reason, or maybe some reason that isn’t useful to speculate. People do terrible things. Sometimes they’re terrible people, and sometimes not, but done is done. It sucks that it happened to you. Crappy things happen to people all the time and you’re one of the people that had a crappy thing (or series of crappy things) happen to them. Spending your energy trying to solve this is a wasted time.

I get that that this doesn’t sound positive or hopeful. I’m not trying to be a ray of sunshine as I think that’s too far from the truth and wouldn’t be useful anyhow. If you are throwing yourself against these walls and stuck on them, the way past them is through understanding that they don’t have to be fixed to be understood. This is only one piece of the healing, but it’s a crucial piece if its a place where you’re repeatedly finding yourself.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

What is a Trauma-Informed Therapist?

What’s this buzzword “trauma-informed” mean? Trauma-informed means that the therapist has been trained to see client behaviors as symptoms of trauma, instead of as dysfunction.

Why is being trauma-informed useful? Understanding things from a trauma perspective allows a therapist to view the client as a whole person from the angle of trauma, with the behaviors as a function of trauma, as a means to an end, a repeating of negative patterns, a way they adapted to their environment. It allows the therapist to see the client outside of negative labels such as: willful, inappropriate, manipulative, or staff-splitting. This is especially useful for people who have developed personality disorders like borderline personality disorder. Seeing clients differently allows us to act differently and treat the behaviors with more care and usefulness.

Trauma-Informed vs. Trauma Specialist Is a trauma-informed therapist the same as a trauma specialist? No. There has been a big push to get therapists trained in trauma-informed care over the past 5 years or so, which is wonderful. This often consists of a single introductory-level training which may be only a couple of hours. A trauma specialist, by contrast, has been training in trauma-related treatments for at least dozens of hours, generally over many years. Personally, I have trained hundreds of hours over a decade in various trauma-related treatments over a decade.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Overwhelmed? Obsessing? A technique for you.

several plants in pots along a sunny windowsill

Zooming in/out

When I am overwhelmed, like thinking about war and climate change and politics, global issues that I have little to no control over, I am zoomed too far out. I’m looking at life through a telescope. I’m needing to change the focus to what is now, here in front of me, that I can change or have control over.

When I’m obsessing, like thinking about day-to-day stressors and my to-do list and all the little pieces that seem to need my attention, I am zoomed too far in. I’m looking at life through a microscope. I’m needing to change the focus to what is now, that I can accomplish and check off, that I can move in the priority if necessary.

I challenge you to change your focus. Notice if you are zoomed too far in or out, and move to a more comfortable middle ground. This is a skill and takes practice, so assume that the lens is going to get out of focus sometimes, and that’s okay, but it is also adjustable and you have the ability to adjust it to be comfortable for you.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

What Does the “Don’t Say Gay” Bill Mean for School Counselors

boy sitting cross-legged, wearing goggles and a hat, making airplane arms, with wooden toy of plane next to him

On March 8, 2022, new legislation was enacted by the Florida Senate by means of House Bill 1557: Parental Rights in Education that will go into effect July 1, 2022. According to the bill, parents and guardians are the ones who shall remain in control of what dialogue their child has in regard to sexual orientation and gender identity, and no school personnel should engage in these discussions as it may interfere with what the family chooses for the child to know/think.

According to the law school counselors follow, counselors do not have to report things to a parent or guardian if the child may be in danger by their reporting. For example, if a child reported abuse by a parent, the counselor is required by law to report that information to the Child Abuse Hotline, but do not have to tell the parent they are making a report. The bill itself states “This subparagraph does not prohibit a school district from adopting procedures that permit school personnel to withhold such information from a parent if a reasonably prudent person would believe that disclosure would result in abuse, abandonment, or neglect…” (section 8c2).

In many homes, a gay or transgender child would be in danger if the parent or guardian was aware of their true nature, so students often hide who they are at home to keep the peace, and express themselves more freely at school. Many schools have become safe havens, allowing children to use their preferred names and pronouns.

What does this law mean for these children, now?

It is useful to delineate that this bill applies only to children in grades K-3 (section 8c3). At those ages, most children do not know their sexual orientation or gender identity, but some will. The bill wants the family to be the primary source of information at these young years and to steer the child in the direct they feel is most appropriate. Of course, there are those families that will use fundamental religion as a weapon against children who are not both heterosexual and cisgender, and this bill does give them the express right to do so.

There was fear around this bill before it was in its final form (as linked in the first paragraph above) that a homosexual teacher could be fired for answering the question “What did you do this weekend?” with “I went to the movies with my wife,” when a heterosexual teacher would have no consequences for saying the exact same thing. However, the bill states that students shall not have “classroom instruction…on sexual orientation or gender identity…that is not developmentally appropriate.” I read this as: it is absolutely developmentally appropriate to say “families look lots of different ways – some people have 1 parent or 2, or grandparents or aunts and uncles who live in the home, some have siblings or none, some have 2 moms or a mom and dad…” even at the Kindergarten level. In fact, I’m certain Sesame Street must have taught me this (and it did: Here and Here and Here and Here). Will a child get in trouble, or be hushed if she says she has 2 dads? No. This is developmentally appropriate.

Will a school counselor have to call the parent when a child says they think they have the wrong body and want to talk about it? Not necessarily, but maybe. Since this bill states that parents are to be kept in the know about what is going with their child, to be “notified about a change in his or her student’s [healthcare] services” (section 8c5), it would be prudent for the counselor to notify the family that the counselor met with the student at the child’s request and the child brought up certain issues or concerns. In this meeting, the counselor would be advised, according to this bill, to remain neutral, teach the child to remain calm, and suggest the child speak to their family about the matter. However, if the child expressed that they would be “abused, abandoned, or neglected” as a result of telling the family, the counselor would be wise to make a note of how the child expressed this, what they presented as the issue, how the counselor responded, and what the session consisted of; this protects the counselor in case the issue ever goes to court.

If the child is in the 4th grade or above, no change needs to take place. Children in progressive schools that have created the kind of safety that allows for use of their preferred name and pronouns can still employ those practice. Schools with a Safe Club that allows kids to express themselves and their feelings and thoughts around sexuality and gender can still hold those meetings. However, it would be best if those meetings were run by the students, for the students, and not led by a staff member, but overseen by a staff member; this ensures that it is not seen as the children being indoctrinated by anyone with an ulterior motive.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Multiple State Licenses

Autumn Hahn, Licensed Mental Health Counselor, Licensed Professional Counselor, Certified Clinical Hypnotherapist

There is a lot of confusion when it comes to getting licensed in multiple states. How do I begin? What is it called? What’s the benefit? I’ll demystify some of that here. I am licensed in Florida, my primary state, and state of residence, since 2010. I got licensed in Georgia in 2021, and have licenses pending in Washington DC and New York.

Why get licensed in multiple states?

The more states I am able to see clients in, the more business I stand to get. I accept insurance, and utilize a number of referral sources to get clients (if you are interested in information on those, please email me and I’ll refer you).

Having a wider base allows me to see the clients who are the most appropriate fit for my specialty. I specialize in trauma, and typically work with only those clients, so I don’t see everyone who needs therapy, only those who seek me out.

Working in multiple states allows me to serve a wider population. Being in telebehavioral health (seeing clients by video) allows me to serve clients in underserved areas, across the entire state.

The American Counseling Association is working on an Interstate Compact that will allow us to practice across state lines for those states participating in the compact, provided you are licensed in one of those states. The American Psychiatric Association has something similar for psychiatrists. You can learn more about the Compact here.

What are the types of license across states?

License by reciprocity – This is outdated. I have heard rumors that some states used to let you practice across state lines simply because you held a license in your state of origin. This is not true now, with the exception of some ability to do so during the pandemic. Do not pursue this. Even if you find it is true for some pandemic-related rules, it will go away at some point soon, if it hasn’t already. This is not a modern law or rule.

License by endorsement – This is your search criteria. If you want to become licensed in another state, search “License by endorsement counselor [state]” and follow the rules on their webpage. You may find that you need to have been licensed for a certain amount of years in your state of origin to qualify (in New York, for example, you have to be licensed for 5 years to qualify), or there may be other rules related to how many practicum hours you need to have completed, certain coursework your school needed to provide you, etc. You may also have to take an additional continuing education course to qualify; New York has a 2 hour child abuse awareness and reporting course everyone has to take. Complete the paperwork and send in your fee. Be aware that you will need access to: your unofficial transcript, your employment and education history, your existing license(s), professional references, and will likely have to send official transcripts, may have to get finger prints done, and more. The process varies by state. The verification and licensing process also varies by state. Georgia, for example, took less than 6 weeks to process all of my information and approve my license. DC, however, has had my paperwork for over 3 months and it is still “pending” with no reason given.

Your title may change as you apply across state lines. I am a Licensed Mental Health Counselor in Florida, but my title in Georgia is Licensed Professional Counselor. It is the same information, same degree, same everything, but certain states have different titles. It does not functionally mean or change anything.

Now what?

Once your secondary (or more) license has been approved, do a couple of things:

Update your referral sources to reflect the new status so you can begin advertising to those states. This includes your Psychology Today profile, website, email signature (mine says I am accepting clients in Florida and Georgia), and any paid referral sites that send you clients where you have a profile.

Go to your CE tracker and enter the new information so you can log all your appropriate CEUs and be certain you don’t miss any renewal dates. Make a note in your calendar to take a course that you need, as appropriate. I use CEBroker for Florida and CEWindow for Georgia.

I hope this information was helpful to you!

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida, Georgia, Nevada, and Virginia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.